[Clinical analyses on moving toes in "painful legs and moving toes"]

Clinical analyses on moving toes were done through two cases of painful legs and moving toes, who had been ill for more than 5 years. Either cases had degenerated lower lumber to upper sacral spines. Clinico-physiological data suggested the presence of polyneuropathy of the sensory type. They showed the lowered skin temperature on the distal portions of lower extremities and acrocyanosis. They, in addition, showed an irregular respiration frequently associated with apnea episodes. Frequency and amplitude of moving toes were increased during Valsalva's maneuver or apnea. Further more, findings were obtained that both the muscle sympathetic nerve activity recorded microneurographically from the tibial nerve and the surface electromyographic activity on the extensor digitorum longs were increased well concomitantly by the occurrence of moving toes. The finding may relevant that moving toes, a type of dyskinesia, may be probably generated by a direct noxious stimulus to the peripheral sensory or autonomic fibers, being strongly influenced by the higher central autonomic (at brain stem?), the extrapyramidal (at corpus striatum?) or some other structures. Moving toes might be a compensatory mechanism to lessen the paucity of blood flow in the lower extremities.